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Common Ski Injuries #9: Shoulder strains

We have previously discussed clavicle fractures and injuries to the AC joint. We also commonly see injuries to the rotator occur with skiing and snowboarding. 

The rotator cuff is a group of 4 muscles, the tendons of which intertwine with the capsule of the shoulder and help provide stability to the joint. Because they lie close to the joint they are effective as stabilizing muscles, but are quite small in comparison to other muscles in the region, and as such are vulnerable to injury. 

The common mechanism is a fall onto the arm in an odd position, although we also see damage occur when a skier fails to let go of a planted ski, and the arm gets pulled in an odd direction. Pain will generally be felt in the side of the shoulder and may refer up to the side of the neck, down the side of the arm, and even into the front of the arm/biceps area. Unlike a humerus fracture, we tend not to see gross bruising and swelling. 

Some degree of pain with shoulder elevation will be present, usually worse with movement out to the side. With a less severe injury, the pain might be worst with the arm out at 70-120 degrees from the body, where the rotator cuff is having to work it’s hardest. With more severe injuries the pan will be constant throughout. With full-thickness tears elevation will usually not be possible. 

A physical examination should be sufficient for diagnosis, however an MRI may be useful in identifying the extent and exact location of the tear. 

The modern approach for overuse tears of the rotator cuff is a non-operative one, focusing on building strength and capacity in the rest of the shoulder. Acute-onset tears, however, can be more difficult to manage, and while we recommend trialing non-operative management initially, the opinion of an orthopedic surgeon may be required for cases that fail to respond. 

Minor rotator cuff injuries may settle with conservative management in 4-8 weeks, however if surgery is required, recovery is usually in the order of 4-6 months. 

If you have suffered a shoulder injury on the slopes then contact us now and let us help guide you on the path to recovery. Inquire about our new physio pricing system.

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